Any advice re: combination of upper and lower punctal plugs

[ReneeL]

Hi all,

I have be suffering from severe dry eye syndrome for years, I have tried everything! My only relief comes from punctual plugs in both my lower & upper tear ducts. Problem when I plug all 4 is I have constant tear overflow .... constantly tearing all day not just when I am exposed to wind or during exercise. I am not sure where all these tears are with just lower plugged? Lower only provides me no help. I cannot function without the plugs.

Question: Is there anything I can do to prevent tearing/reflux tearing? Does anyone have advice on how to limit tear overflow? I am trying to find away to live with all 4 plugged...

Also, Could anyone recommend a dry eye expert doc. in the Minneapolis, Minnesota area?

Thank you and please help if you can.

RL

[Rebecca Petris]

Dear RL,

Welcome to Dry Eye Talk!

So 4x occlusion is too much and 2x is not enough? Maybe time to investigate different plug brands and designs if you have not already? In particular, perhaps EagleVision's flow controller plugs (which permit more drainage than their standard plugs) in the lowers might make having upper plugs more workable? Mind you I don't have much experience at all with the flow controllers, it just occurs to me as something that "sounds sensible" for this kind of situation.

[dianat]

Hi, Renee.

I can empathize with your situation. I am cauterized in all four punctae. Lower plugs/cautery wasn't enough for me. I do overflow pretty much constantly. It's terrible. I've been this way for years now and just keep a tisse nearby at all times. I have no solution for you.

One interesting note for me is that when I'm having a really "good eye day" as I call them, my eyes tear far less. I suspect my tear film is a better quality on that particular day. When I'm really watery and blotting several times an hour, it's usually on a bad, burning, salty day.

I still don't know what causes the fluxuation, but it can be dramatic...I can be pretty good one day and exceptionally horrible the next. Lucy describes factors in her comfort as "insignificant as the color of her socks". I'd have to concur.

Do you wear air tight goggles in the car and outside? These do preserve my comfort a bit, but I don't think they are answer you seek.

D

[Flick]

Hi Renee,

I can't remember the name of it but there is one type of punctal plug that partially blocks your punctum, ie it lets some tears through. You might want to try that.

Good luck!


(oops Rebecca beat me to it and knew the name)

[dianat]

Hey, you two. I'm trying to answer here...